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Alfredo Velasco Martinez

Dentist

Dental Providers

3445 Henderson Dr, Jacksonville, NC 28546-5233

PECOS Enrollment

This provider is enrolled in PECOS as ALFREDO MARTINEZ.

Based on the most recent information from CMS, provider Alfredo Velasco Martinez is legally eligible to order and refer claims for DME services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 9 days ago.

Profile Details

Provider ID
1184265563
Provider Type
Individual
Full Name
Martinez, Alfredo Velasco
Title
Dr.
Credential
DDS

Gender
Male
Sole Proprietor
Yes
Enumeration Date
10/7/2019
Last Updated
6/12/2023

Contact Information

Practice Location

3445 Henderson Dr, Jacksonville, NC 28546-5233

(910) 347-1283

(910) 347-2153

Mailing Location

Commanding Officer, 2d Denbn/Ndc, Psc 20130 315 Mchugh Blvd, Camp Lejeune, NC 28542-0130

(910) 451-2208

(910) 451-8479

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 13316 North Carolina
Code 122300000X	Description Dentist Dental Providers	License 104078 California

Alfredo Velasco Martinez

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Whitley, Daniel

Futrell, Stephen Craig

Williams, Michael Sean

Ambrose, Andrew

K. Jasinski, D.M.D., P.C.

Bell, Thomas W

Anderson And Slack Pa

Patel, Jesal

Williams, Matthew Stephen

Pieper, Justin Meyers